早期急性胆源性胰腺炎的内镜治疗  

Early endoscopic therapy for acute biliary pancreatitis

作　　者：彭海峰[1] 闫玉矿[1] 郑通标[1] 李德宁[1] 段君英[1] 

机构地区：[1]深圳市龙岗中心医院普外科,518116

出　　处：《中华普通外科杂志》2005年第3期137-139,共3页Chinese Journal of General Surgery

基　　金：深圳市科技计划立项项目 (2 0 0 10 413 8)

摘　　要：目的　评价急性胆源性胰腺炎内镜治疗的临床效果。方法　2 0 0 0年10月至2 0 0 4年3月共收治急性胆源性胰腺炎36例,其中急诊内镜治疗(内镜组) 2 0例,2 4h内行逆行胰胆管造影术、内镜下乳头括约肌切开后用网篮取石或碎石网篮碎石后气囊取石术及内镜下鼻胆管引流术;保守或急诊外科手术治疗(对照组) 16例。结果　内镜组治疗的成功率为95 % ,未发生与内镜操作有关的严重并发症;与对照组相比,内镜组术后腹痛缓解快,住院时间短(P <0 . 0 1) ,从术后第2天开始血及尿淀粉酶明显降低(P <0 .0 5 ) ,第3天降低更为明显(P <0 .0 1)。结论　内镜治疗解除了胆胰管开口的梗阻,通畅了胆胰液的引流,微创、安全、有效,是治疗急性胆源性胰腺炎的理想方法。Objective To evaluate the therapeutic effect of duodenoscopy in the early treatment of acute biliary pancreatitis (ABP).Methods Twenty ABP cases admitted from Oct.2000 to Mar.2004 received emergent endoscopic retrograde cholongiopancreatography (ERCP), sphincterotomy (EST) plus endoscopic lithotomy and endoscope naso-biliary drainage (ENBD).Other 16 cases were treated with conservative therapy or open surgery.Results Successful rate of endoscopic management was 95%.There were no severe complications nor mortality in this group.The duration of symptoms and hospitalization in endoscopy group were significantly shorter than control group ( P <0.01).Serum and urine amylase levels in endoscopy group were significantly lower than in control group from the second day and after ( P <0.05).Conclusion Endocsopy treatment relieves the orifice obstruction of cholecystopancreatic duct, decreases the pressure of intra- cholecystopancreatic duct, and is safe, mini-invasive and highly effective for the treatment of acute biliary pancreatitis.

关 键 词：急性胆源性胰腺炎 内镜下鼻胆管引流术 逆行胰胆管造影术 早期 急诊内镜治疗 外科手术治疗 2004年 2000年 乳头括约肌 严重并发症 临床效果 碎石网篮 网篮取石 内镜操作 术后腹痛 住院时间 尿淀粉酶 对照组 24h 取石术 碎石后 切开后 胆胰管 

分 类 号：R576[医药卫生—消化系统]